Tuesday, January 28, 2014

Parents of diabetic Lexington boy push for state law to allow school staff to administer insulin

Ed Gibson leaves work four or more times a week to go to
Cassidy Elementary School to give his son Henry, 7, insulin shots.

Gibson,
a commercial real estate appraiser in Lexington, said he is more than
willing to take care of his boy. But he is frustrated that Kentucky
regulations and law do not allow school staff other than licensed health
professionals to give Henry his insulin, even if the staff has
training.

Henry Gibson

With Type 1 diabetes, Henry's body does not produce
insulin, a hormone that is needed to convert sugar, starches and other
food into energy, according to the American Diabetes Association
website.

Fayette County Public Schools, like many other Kentucky
school districts, is short on school nurses. The part-time nurse at
Cassidy typically gives Henry one injection each day after lunch, his
parents say. The second-grader usually ends up needing more.

"The
frustrating part about it is that there is a teacher's aide at the
school who raised a child with Type 1 diabetes. She's more qualified
than we are to care for somebody with diabetes," Gibson said.

Also,
"Henry's primary baby sitter, who has given Henry hundreds of shots, is
right there (working) in the after-school program" and often works as a
substitute teacher, Gibson said. But staff members who are trained or
have offered to get training so they could give Henry a shot are not
allowed by Kentucky law to give him an injection at school.

House
Bill 98, sponsored by state Rep. Bob Damron, D-Nicholasville, would
change the situation for Henry and others, his parents said. HB 98 and
Senate Bill 30, introduced by Sen. Julie Denton, R-Louisville, would
allow school staff who aren't licensed health care professionals — but
who have been trained by a health care professional — to administer or
help a student self-administer insulin. The current law allows school
staff to administer glucagon, which is emergency medication for someone
with diabetes who is unconscious from a severe insulin reaction.

Under
the proposed legislation, the individual administering or helping
students self-administer the insulin must complete a program consistent
with training programs developed by the American Diabetes Association.

The
decision to administer the insulin to students would be voluntary for
school staff, and parents would have to sign a waiver, Damron said. HB
98, was approved Thursday in Frankfort by the House Health and Welfare
Committee and could go to the state House of Representatives on Monday
for a vote.

Allowing trained school staff to administer insulin
"is a law in about 35 other states," Damron said last week. "It's not
meant to replace a school nurse; it's meant to supplement the protection
of children."

Administering insulin at school is at issue in a
pending federal lawsuit in Lexington that was filed in 2009 against the
Scott County Board of Education by the family of a child identified only
as R.K.

R.K. initially was not permitted to attend his
neighborhood school, Eastern Elementary, which lacked a full-time nurse,
and was assigned to Anne Mason Elementary, another school in Scott
County, which had a full-time nurse who could give him insulin,
according to court documents. The lawsuit alleges that the decision to
assign R.K. to the non-neighborhood school constituted discrimination.

"Not
all kids with Type 1 diabetes necessarily need assistance from a
licensed nurse," said Justin Gilbert, the attorney representing R.K.'s
family. "Some can self-administer insulin. Others just need help from a
trained lay person. We are troubled by the notion that kids with
diabetes must be segregated to certain schools having a nurse."

Attorneys
for the Scott County School Board did not return a message last week.
But in court documents, they said the school board did not discriminate
against R.K. Additionally, the documents filed on behalf of the school
board said Scott County schools did not train employees who weren't
nurses to monitor the student's blood sugar and administer insulin
because that could violate Kentucky regulations.

The federal case
"is an example of what we are trying to prevent with this bill,' said
Stewart Perry, past national chairman of the American Diabetes
Association and the association's current state advocacy volunteer
leader.

Perry said he had heard complaints that children in
Kentucky with diabetes are being home-schooled or, like R.K.,
transferred because trained school staff can't give them insulin.

Even
in cases in which students can give themselves insulin shots, they have
problems in Kentucky schools, Perry said. The American Diabetes
Association has received complaints that students with diabetes are
being denied the opportunity to play sports, become cheerleaders and go
on field trips, he said, because licensed nurses are not available
during those events. Stewart said that in 20 years of working with the
American Diabetes Association on a national level, he had not heard of
one situation "of anybody being injured, anybody being killed or
anything happening" because a school staff member without a health care
license had given insulin.

"The American Diabetes Association
believes that every school should have a school nurse," said Perry. "But
even if there is a school nurse, we need trained unlicensed personnel
to augment that school nurse."
Fayette County Superintendent Tom
Shelton said he thought the legislation was a positive move. "Anything
that we are able to do toward the health needs of our students is
certainly welcome news, " he said.

Fayette County can afford only
part-time nurses at schools, the superintendent said. The district has
an interim contract with the Lexington- Fayette County Health Department
to provide school nurses that the district is funding entirely. "We are
reviewing proposals for a new model program to begin next school year,"
Shelton said.

A fiscal note attached to HB 98 said there would be
no cost to the state if the bill were enacted. The Kentucky Department
of Education projected there could be a "small fiscal impact" on school
districts if they paid to train school staff, the note said. Damron said
the cost would be less than $1,000 for each school district, which he
said was less than hiring a school nurse.

There are an estimated
2,564 students identified with diabetes in the public schools, the
fiscal note said. But Perry said the numbers could be higher.

Meanwhile,
Henry is learning to give himself insulin injections and to count the
carbohydrates in his food, but he can't do that alone at school yet, his
father and mother, Jennifer Allen Gibson, said.

"The way the
blood-sugar levels fluctuate, Henry could need shots much more often
than just at lunch," when he typically receives one from the school
nurse, Ed Gibson said. "He could need it in the morning; he almost
always needs one in the afternoon after an afternoon snack."

During
the day, the school staff texts Ed Gibson about Henry's blood-sugar
levels and tells Gibson what Henry is having for a snack so the father
can decide whether he needs to go to school to give Henry an injection.

"The
situation is OK for me because I'm relatively close to school," said
Gibson. And, because he is self-employed, Gibson said, he can work
evenings and weekends to make up the time he loses during the day. But
Gibson said he knew other parents have a harder time leaving work at
unscheduled times.

Henry's mother said she thought allowing school
staff to be trained to administer insulin could bring increased and
consistent care across the state.

"It's simply people that are going to be willing to help out for the good of the kids," Jennifer Gibson said.

3 comments:

Anonymous
said...

It is not an either/or proposition that some how $ 1000 worth of training for insulin injections is going to somehow replace the expense/need of a district having a school nurse.

Who doesn't want to help support a student but when are we going to start drawing a line? You spend four years and then two more taking course work to be an educator and then legislature keeps dropping these non teaching expectations in your lap with the idea that a few hours of PD will make you into a medical assistant or suicide prevention counselor. We don't ask nurses to help kids with their math homework, so why are we expecting educators to provide medical care?

As an employee of Cassidy, this article is laden with errors. I don't want to breach confidentiality, but the father's accusations about the school, and about school health care for the boy in question, are simply not correct.

I studied the idea of truth in the media in college. Those of us who work at Cassidy know the truth.

Bad bad schools! Don't you know you are responsible for driving kids to the building, feeding the kids, protecting the kids, ensuring they have up to date vaccinations, eye exams, hearing exams identifying if they are suicide, abuse or any other risk, providing them with clothing and ... oh yeah teaching so that they are competitive for global work force expectations that have yet to develop. Didn't you know you are also suppose to provide on sight medical care too?

Sorry, not trying to be a jerk, but maybe a parent might need to take their lunch hour to come give their own child their insulin shot instead of cruising facebook at noon while they eat their lean cuisines.

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